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Disease management: findings from leading state programs
State Coverage Initiatives Issue Brief : a National Initiative of the Robert Wood Johnson Foundation
|January 1, 2003
Summary
Disease management programs aim to lower healthcare costs by enhancing the health of chronically ill individuals. Over 20 states are implementing these Medicaid programs for various populations.
Area of Science:
- Health Services Research
- Public Health Policy
Background:
- Chronic illness management presents significant healthcare cost challenges.
- Disease management programs (DMPs) are increasingly adopted to mitigate these costs.
- Medicaid programs are central to managing the health of vulnerable, chronically ill populations.
Purpose of the Study:
- To examine the current landscape of Medicaid disease management program implementation.
- To understand the strategies states are employing to contain costs through DMPs.
Main Methods:
- Analysis of state-level initiatives in Medicaid program development.
- Review of program structures for primary care case management and fee-for-service populations.
Main Results:
- More than 20 states are actively developing or implementing DMPs.
- Programs target both primary care case management and fee-for-service Medicaid beneficiaries.
- Focus on cost containment through improved health outcomes for the chronically ill.
Conclusions:
- Medicaid disease management programs are a growing strategy for states to manage chronic illness costs.
- Implementation varies across states, targeting diverse Medicaid populations.
- The trend indicates a significant policy shift towards proactive chronic care management within Medicaid.